Athletes' injury risk altered by menstrual cycle, research indicates

Yahoo

14-05-2025

Canadian coxswain Kristen Kit has had a long, successful career competing for Canada in the women's eight boat, winning two Olympic medals in the process.
But in all her years on the national team, Kit has never taken a day off for her menstrual cramps.
"Never, in my 16 years," she said in an interview with CBC Sports. "I don't think I've ever known when anyone on my team, myself included, took a practice off or took a day off for cramps."
For some, menstrual cramps can feel like intense throbbing in the lower abdomen and pain that radiates to your lower back and thighs, but recent research from the University of Vigo in Pontevedra, Spain has found that a female athlete's hormonal changes could also lead to potential injuries.
"I am mind blown by this," Kit said. "For Olympic athletes, why do we not have someone coming to talk with us about this stuff? I don't want to get injured."
The same study found that a woman's monthly hormonal changes could alter biomechanics and movement patterns, creating a higher chance for injury.
The study also indicates that female athletes have a harder time balancing, or building and rebuilding muscle tissue, when hormones like estrogen and progesterone increase in the body.
According to Joanna Blodgett, a Canadian researcher who works as a senior research fellow at the Institute of Sport Exercise and Health in London, sports science only focuses about six per cent of its research exclusively on female athletes. As a result, "most athlete training programs, injury prevention strategies, and recovery protocols" are designed for male athletes, said Blodgett.
WATCH | Link between menstruation and injuries:
The research also indicates that an athlete's risk of injury is significantly higher during the luteal phase of a female's menstrual cycle, which was found to be the five days leading up to menstruation.
"Seeing that injury risk isn't the same across the menstrual cycle is very important," Blodgett said. "Of course, we can't control competitive fixture schedules against every athlete's cycle."
Kit has suffered several injuries in her career, most of which she recalls happening a few days before getting her period.
"[In January] I was running with my dog, and hit a rock wrong, and twisted my ankle," she said. "I wonder too, if I'm just a little bit less paying attention leading up to my period. l really think five days before I am kind of all over the place.
"In bike racing, all of my big crashes seem to happen right before my period. When I shattered my collarbone … I got my period a few days later, waiting for surgery."
According to Margo Adam, an assistant professor at the University of Alberta whose research focuses on menstrual function and dysfunction amongst women athletes, many report feeling distracted while on their period.
"Athletes talk about how women had to miss part of their warm up, for example, because they needed an extra break in the washroom," she told CBC Sports. "In sport, often you're trying to think externally. You're thinking about a strategy. You're trying to do things that are outside of your body, and when you get twinges, when you get cramps, when you get pain that is distracting, and it takes away from the different strategic and bigger picture elements that you might be really trying to focus on."
She adds that being distracted in sport can lead to potentially different types of failures or mistakes.
It is worth noting that many research studies have also found many female athletes experience amenorrhea, which means that they do not have a period. As a result, these athletes are not subjected to the hormonal changes from the menstrual cycle.
Further research is urgently needed on this topic to understand the influence of the menstrual cycle on injury risk in order to prevent more injuries in sport.
"If we want to create a more equitable playing field in sports for women, the research has to catch up," said Blodgett. "This means more funding, prioritisation, and long-term commitment to better research that will inform the best strategies to optimise female athlete health and performance."
In soccer, athletes reportedly have a higher likelihood of tearing their ACL (anterior cruciate ligament). Females specifically have a 2.8 times greater chance of the injury than their male counterparts, according to data collected on 28 females cited in a 1999 study by researchers at the University of Minnesota. This is leading researchers like Blodgett to begin exploring reasons for the gap and how menstrual cycle are factored in.
"We were seeing a lot of anecdotal evidence from players — often in the media — linking ACL injuries to specific points in their menstrual cycle. For example, a player might talk about the exact day they got injured," she said.
One study, published in the International Journal of Environmental Research and Public Health, found that among 74 female professional soccer players, 30 per cent had cycle irregularities, and 74 per cent had cycle-related symptoms.
Canadian soccer player Cloé Lacasse and Tierna Davidson of the USA's senior women's national team, are two of the national team stars who have suffered ACL tears recently.
Blodgett said understanding the link lends itself to start thinking about player care differently.
"We can't control competitive fixture schedules against every athlete's cycle. Instead, it's about being smarter with things like injury prevention strategies, recovery, and how we communicate with athletes," she said. "If we know there are specific windows where injury risk might be higher, we can begin to build more tailored, proactive approaches."
Organizations such as FIFA, the global governing body for soccer, are beginning to recognize the link between injuries and menstruation. The U.K.'s Kingston University announced earlier this month it will receive funding from FIFA to investigate the link between the menstrual cycle and the high rate of ACL injuries in women's football.
The funding is provided through FIFA's Research Scholarship scheme in hopes of making developments in training, recovery and medical care designed appropriately for female physiology.
Canadian soccer veteran Desiree Scott is in full support of this specific research.
"Especially in the last few years, there's been way too many ACL tears. So if we can find a solution that's contributing to that, let's put the investment in to research that and and help a gal out," the 37-year-old told CBC Sports.
She said she uses a menstruation tracking app to understand how her energy levels and body is affected both for performance and for everyday life.
And according to Adam, more research will allow for increased career longevity for female athletes, as opposed to just "flash-in-the-pan performances."
"We know the trajectories to high performance typically aren't linear for women, so we need to allow that flexibility in that space," she said.